San Lazaro Hospital, Manila, Philippines.
School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
PLoS Negl Trop Dis. 2022 Jul 19;16(7):e0010595. doi: 10.1371/journal.pntd.0010595. eCollection 2022 Jul.
Rabies remains a public health problem in the Philippines despite the widespread provision of rabies vaccines and rabies immunoglobulin (RIG) as post-exposure prophylaxis (PEP). Detailed descriptions of recent human rabies cases in the Philippines are scarce. This study aimed to describe the clinical, epidemiological, and spatial features of human rabies cases between January 1, 2006, and December 31, 2015. We conducted a retrospective hospital-based case record review of all patients admitted to one referral hospital in Manila who received a clinical diagnosis of rabies. During the 10-year study period there were 575 patients (average 57.5 cases per year, range 57 to 119) with a final diagnosis of rabies. Most patients were male (n = 404, 70.3%) and aged ≥ 20 years (n = 433, 75.3%). Patients mostly came from the National Capital Region (n = 160, 28.0%) and the adjacent Regions III (n = 197, 34.4%) and IV-A (n = 168, 29.4%). Case mapping and heatmaps showed that human rabies cases were continuously observed in similar areas throughout the study period. Most patients had hydrophobia (n = 444, 95.5%) and/or aerophobia (n = 432, 93.3%). The leading causative animals were dogs (n = 421, 96.3%) and cats (n = 16, 3.7%). Among 437 patients with animal exposure history, only 42 (9.6%) had been administered at least one rabies vaccine. Two patients (0.5%), young children bitten on their face, had received and a full course of rabies vaccine. Human rabies patients were continuously admitted to the hospital, with no notable decline over the study period. The geographical area in which human rabies cases commonly occurred also did not change. Few patients received PEP and there were two suspected cases of PEP failure. The retrospective design of this study was a limitation; thus, prospective studies are required.
尽管在菲律宾广泛提供狂犬病疫苗和狂犬病免疫球蛋白（RIG）作为暴露后预防（PEP），狂犬病仍然是一个公共卫生问题。最近菲律宾发生的人类狂犬病病例的详细描述很少。本研究旨在描述 2006 年 1 月 1 日至 2015 年 12 月 31 日期间在马尼拉一家转诊医院住院的所有患者的临床、流行病学和空间特征。我们对所有被临床诊断为狂犬病的患者进行了回顾性基于医院的病例记录审查。在 10 年的研究期间，共有 575 名患者（平均每年 57.5 例，范围为 57 至 119 例）被确诊患有狂犬病。大多数患者为男性（n = 404，70.3%）和年龄≥20 岁（n = 433，75.3%）。患者主要来自国家首都地区（n = 160，28.0%）和相邻的第 III 区（n = 197，34.4%）和第 IV-A 区（n = 168，29.4%）。病例绘图和热点图显示，在整个研究期间，人类狂犬病病例在相似地区持续观察到。大多数患者有恐水症（n = 444，95.5%）和/或恐风症（n = 432，93.3%）。主要致病动物是狗（n = 421，96.3%）和猫（n = 16，3.7%）。在 437 名有动物接触史的患者中，只有 42 名（9.6%）至少接种过一剂狂犬病疫苗。两名患者（0.5%），即脸部被咬伤的幼儿，已接受并完成了狂犬病疫苗全程接种。人类狂犬病患者持续住院，在研究期间没有明显下降。人类狂犬病病例常见发生的地理区域也没有改变。很少有患者接受 PEP，有两例疑似 PEP 失败。本研究的回顾性设计是一个限制；因此，需要进行前瞻性研究。
